Associate/Diploma RN, Pain Management (RN, C)

The Pain Management certification indicates specialization in the field of caring for patients with acute and chronic pain. This pain can be from a variety of sources, but the Pain Management certified nurse is able to properly assess the patient to identify modalities that may help patients to cope with managing their pain.
In order to take the Pain Management certification exam, the applicant must be a licensed Registered Nurse with an Associate Degree or diploma from an accredited 2-year RN program. The RN must have worked at least 2 years in a full-time capacity in pain management or a related field, with at least 2,000 hours within the past 3 years. In addition, at least 30 hours of continuing education hours should have been completed in pain management nursing over the past 3 years.

The Pain Management certification exam is offered throughout the year at testing centers across the United States. The RN has 90 days in which to take the exam after receiving the test admission ticket. The fee to take the exam is $230 for members of the American Nurses Association (ANA) and $370 for non-members.

The exam consists of 175 multiple-choice questions with 25 of those questions used for pretesting purposes for possible use on future exams. The Pain Management certification exam tests the RN's knowledge of specific disease states and conditions that are known to cause acute or chronic pain in the patient. Questions regarding management of the patient's pain through various nursing interventions are also included. There are also questions pertaining to monitoring the patient for treatment effectiveness, as well as providing patient and caregiver education regarding managing pain.

Pain Management certification is valid for 3 years. At the end of that time period, the licensed RN must have completed at least 1,000 hours of employment as a pain management nurse. In addition, at least 75 continuing education hours should have been completed or other educational activities should have been completed as outlined by the American Nurses Credentialing Center. The fee for renewal is $160 for ANA members and $290 for non-members as long as the practice hour and continuing education hour requirements are met. For those who wish to retake the exam in order to recertify, the fee is $230 for ANA members and $370 for non-members.

For more information regarding the Pain Management certification for the Associate Degree or diploma RN, go to www.nursingworld.org or www.nursecredentialing.org, or visit the American Society for Pain Management Nursing at www.aspmn.org.

Nursing Certification Central

Pain Management Nursing Practice Test

1. Which of the following refers to the direct stimulation by chemical, thermal, or mechanical nociceptors, which results in the transmission of electrical signals along neural pathways?

a. somatic pain
b. visceral pain
c. nociceptive pain
d. neuropathic pain

2. Melzack postulated that information from multiple neural systems integrates and produces the pain experience. Which of the following is the title of Melzack's theory?

a. specificity theory
b. neuromatrix model of pain
c. gate control theory
d. pattern theory

3. Which of the following pain conditions features chronic moderate to severe soft tissue pain and allodynia?

a. temporomandibular joint disorder
b. radiculopathy
c. fibromyalgia syndrome
d. peripheral neuropathy

4. Which of the following statements is accurate regarding the most effective management of cancer pain?

a. Better education of health-care providers on recommended guidelines for treating pain is essential.
b. The avoidance of opioid usage is necessary to prevent future addiction problems.
c. The administration of nonsteroidal anti-inflammatory drugs (NSAIDs) subcutaneously is effective for maximum pain control.
d. The continuous administration of opioids subcutaneously is an extremely expensive therapy.

5. Central sensitization is of paramount importance in the pathogenesis of chronic pain. The definition of central sensitization is a complex condition in which an increase in the excitability of CNS neurons results in unusual senses and responses to various stimuli. Which of the statements below best describes the dorsal horn mechanism known as hyperalgesia?

a. an amplified response to painful stimuli
b. a progressive increase in the scale of response to C fiber activity
c. the concept that cellular memory for pain may lead to future increased responses to nociceptive stimuli
d. the development of a situation in which, due to recurring excitement of a neuron, the impulse threshold decreases and the strength of the response increases

Pain Management Nursing Answers and Explanations

1. C: Nociception refers to programming and recognizing deleterious (noxious) stimuli when it transmits to a sensory receptor (nociceptor). The stimulus and reaction of the nociceptors result in the sensation of pain that is known as nociceptive pain. Nociceptive pain subtypes include visceral pain (from the organs or the lining of the organs), often characterized by cramping, and somatic pain (skin, subcutaneous layers, bones, muscles, and blood vessels) frequently described as specific to a localized area, throbbing, stabbing, or aching. Nociceptors respond in distinctive ways to severe thermal, chemical, and mechanical stimuli. Neuropathic pain (pathological) originates in the peripheral or central nervous system and may be prolonged by unusual somatosensory processing in these systems. The subtypes of neuropathic pain include "central generator," which is deafferentation, central, or phantom pain, or sympathetic pain. The second type is "peripheral generator," which begins in the nerve root, plexus, or nerve.

2. B: Melzack promoted the neuromatrix model of pain, which maintains that pain develops from complicated neuromatrices consisting of parallel and redundant neurological and neurochemical systems inside the brain, which are not bound by activity in an isolated sensory cortex. Information received from the various systems combines in the brain to produce the pain experience. The specificity theory hypothesizes that pain is not a punishment for misdeeds, as believed in ancient times, or an emotion, as postulated by Aristotle, but related to specific anatomical and physiological functions. Melzack and Wall's gate control theory states that pain is a multifaceted perceptual experience that evolves from that individual's exclusive psychological and physiological factors. The pattern theory evolved to explain unique examples of pain such as phantom limb sensation, allodynia, or hyperalgesia.

3. C. Fibromyalgia syndrome refers to chronic mild to severe soft-tissue pain and allodynia. Symptoms include continuous pain, which may vary in intensity, interrupting sleep patterns. Central sensitization results in a magnified awareness of pain. Chronic exhaustion plus muscle and joint stiffness near the maximum range of motion frequently accompany this condition. Temporomandibular joint dysfunction is a frequent cause of orofacial pain. Radiculopathy refers to a spinal nerve root disorder. Peripheral neuropathy is associated with injury to a specific peripheral nerve.

4. A: The education of health-care professionals on the latest recommended guidelines for cancer pain management results in optimal pain management. Opioid therapy is more than 75% effective in treating cancer pain. NSAIDs, administered orally, are effective in certain cancer pain syndromes. Subcutaneous infusion of opioids is a cost savings for the patient because it does not demand the skill level of other routes of administration.

5. A: Hyperalgesia is an exaggerated or amplified response to painful stimuli, which may manifest itself in various ways, most likely due to the cause of the peripheral stimulus. Neuropathic pain sufferers frequently complain of cutaneous hypersensitivity and amplified pain due to mechanical and thermal stimuli. Windup is a progressive increase in the scale of response to C fiber activity. Long-term potentiation is the concept that a cellular memory for pain may lead to future increased responses to nociceptive stimuli. The development of a situation in which, due to recurring excitement of a neuron, the impulse threshold decreases and the strength of the response increases is called facilitation.

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Last Updated: 07/05/2018


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